CHILD AND ADOLESCENT PSYCHOANALYSIS

This space is devoted to work with infants, children, adolescents and young adults. The material is drawn from various sources in our organization, and we will continue to expand the topics covered to include culturally relevant material about families and programs around the world.

Our inaugural articles, geared for the public include a discussion of sleeping arrangements, winning and losing, finding the correct distance or closeness with adolescents and a brief description of phobias geared towards a young adult audience. We look forward to collaborating with fellow analysts to enhance the site and to create an archive that might be useful to the public and members alike, so please send information about your school, your programme, your work in the community to Rhoda Bawdekar: Rhoda@ipa.org.uk. Translations and material in other languages will be coming.

There are many opinions about sleeping with your baby. There are groups that believe that sleeping with your baby promotes attachment. Some Pediatric Associations feel that it is unsafe for the infant. Did you know that helping your child sleep independently could promote their development?

The Lucy Daniels Center does not recommend family beds because we do not believe that this arrangement supports young children's developmental needs. Changing needs for comfort: Many parents are drawn to a family bed because they know that their physical presence during the night helps their children feel close to and comforted by them. However, we believe that the children's needs for intimacy and comfort change they grow. During infancy, parents provide intimacy and comfort almost exclusively through the senses: touches, smells and sounds. We call this way of providing love the "core comforting relationship." A shift begins by the end of the first year of life. At that point, words and facial and bodily gestures are an important vehicle for the emotional interchange between child and parent. We call this a "verbally based comforting relationship." The shift from a core to a verbally based comforting relationship occurs over time. This transition is important because it enables children to carry within themselves the profound level of safety and security originally provided by the core comforting relationship. If, in order to feel secure, children continue to require the presence of their parents, they may feel excessively dependent and insecure when on their own.

Therefore, Lucy Daniels Center educators and mental health clinicians emphasize the importance of handing over the baton — of children taking the core comforting relationship that first exists between themselves and their parent, and making it exist within themselves. We call the process by which this change occurs "internalization." Older children achieve stable self-confidence when internalization of the core comforting relationship has occurred. Parental hugs and kisses become little boosters for what children feel inside, rather than being necessary for a feeling of security. Nurturing the ability to tolerate separation: Children's ability to master separation depends upon their successful internalization of parental comfort. This skill involves both a behavioral ability to be physically alone, as well as an internal capacity to feel comfortable, confident and fully vital when physically alone. Some children are not able to be physically alone because they do not have an internal capacity to be alone; others can manage the behavioral separation but are shackled with painful feelings and a diminishment of vitality. Children confront the major separation of ordinary daily life at bedtime. Bedtime offers children the opportunity to master the painful feeling of aloneness through progressing along the path of internalizing of the comforting parent. Children are shepherded toward strengthening their own resources by bedtime rituals, check-ins, reassurances and similar limited comforts. The basis of one of our concerns about the family bed is that such an arrangement has the risk of keeping children excessively dependent upon the core comforting relationship, upon others for their basic sense of safety in the world. It is much better if this sense of safety resides and abides inside children themselves. Accepting the parental relationship: We have a second concern about the family bed. It is important that children understand and accept the reality that their parents have a relationship that has other dimensions in addition to their mutual parenting. Up through age 3, children believe that parents exist for only one reason: to parent them. This is a healthy, inevitable, self-orientation of early childhood. Around age 3, children develop the ability to understand that their parents have other interests. For example, a 2-year-old child can understand that his or her mother goes to work, but not that she might work in part because she enjoys being productive or creative. The child would only comprehend that she goes to work in order to make money and to take care of him or her. One of the most emotionally important realizations of 3-year-old children is that their parents are also husband and wife in the sense that they have a relationship beyond their relationship as Mommy and Daddy. Children generally understand, perhaps even without having to be taught, that this special relationship includes a physical relationship. When parents have their own private bedroom, children usually understand that there is some kind of special relationship or activity occurring there, although they would not necessarily understand any details. It is very important that children in the early childhood years recognize, accept and value this relationship between parents so that they can use such an understanding of the marital relationship as models for their own life path. However, children tend to resist accepting their parents' independent relationship. Children want to be the one and only. Ideally, children come to feel that they are the center of their parents' lives, but that their parents have other extremely important centers, including their spouse or partner. Children who don't accept their parent's relationship may remain excessively self-centered and less able to understand that people have motivations and needs that don't concern them. They are less able to chart within themselves a path toward a healthy, adult, balanced life. Unfortunately, the use of the parental bed supports the tendencies within the child to believe that the parents exist only for them. Separate beds force the child to face a hard truth, to relinquish a sense of being at the center of the universe. The pain involved in accepting this is in fact one reason that some children resist sleeping alone. There is a case to be made for the use of a family bed. However, we do not believe that it is a sufficient case, or in the child's fullest interest, when all factors are considered. We hope that understanding the situation from the standpoint of their child's developmental needs will assist parents in their choices. For excellent books to read with your toddler or preschooler on the topic of "Feeling Strong on my Own," check out Lucy's Book Club. The book "My Own Big Bed" by Anna Grossnickle Hines is a good choice for children from birth to age 6.

"Self-esteem" is one of the most discussed issues among parents and infant and child developmentalists. Psychologically, self-esteem can become quite complicated, but let's stick to the basics and see if we can shed some light on it. Self-esteem can be defined as a confidence and satisfaction in oneself. How can this be achieved? How does one's own internal sense of self-esteem relate to external assessment of those around us? In general, of course, the real key to self-esteem is loving and encouraging your child — life itself will provide enough problems — loving and valuing the child for himself or herself, who he or she is. This is often easier said than done, especially if the parents have not been loved and valued. Paying attention to your child, listening to her, being interested in her and how she feels and what she thinks - all these help solidify the child's internal self-cohesion and give her the sense she is of value — i.e., self-esteem. What else might one do to help enhance self-esteem? It is crucial to understand feelings — how they work and are handled or mishandled. Feelings cause behaviors. We can understand behavior by understanding the feelings which are motivating the behaviors. Human beings have approximately nine built-in, universal feelings: interest, enjoyment, surprise, distress, anger, fear, shame, disgust (reaction to noxious tastes), and dissmell (reaction to noxious odors). We'll discuss these in more detail another time. Use reward and praise systems rather than punishment whenever possible — focus on the positives rather than the flaws. In the midst the complex period of adolescence, for example, parents do well to consider three or four praises for every one criticism. Convey a sense of reality and encourage genuine competency. False praise is not useful for the child's reality processing and self-esteem in dealing with the external world. Try not to use fear and shame as motivators. Fear and shame are quite toxic feelings and erode self-esteem. The development of our internal psychological world is quite complex. Yet, helping a child achieve a solid sense of self, optimism, and confidence is not all that difficult. Some attention to the issues raised above can be rather useful in enhancing potential and preventing problems.

Some parents seem to let their
teens have free reign, and some seem to cling to trying to have the same
type of control and influence over their teen that they had when their
teen was small. Here is a psychoanalysts ideas about the space in
between those two positions.

Adolescence is a time when young people are pressured from inside and outside to try new things -- this makes sense since they are emerging from the protective world of the family to the larger world of opportunities, risks, mastery, excitement and dangers. Teenagers seek out novelty and heightened sources of stimulation, some as benign as roller coasters and scary horror movies, some as dangerous as substance abuse, reckless driving, unsafe sex, or delinquency. Teenagers need the courage to try new things, but the wisdom to keep themselves safe. Significant changes in brain structure and functioning mean they may do things with less judgment, caution or rational thinking even than when they were a bit younger. So the action side is legislated for by neurological and biological shifts. But what about safety? How can we help teenagers be brave but not stupid, take chances but include safeguards, be adventurous, creative and innovative but still retain a connection with past and current reality, plus future consequences? Anglo-American attitudes have always stressed the need for adolescents to physically separate and reject parents and other adults. This leaves a vacuum that is quickly filled by peers, advertising, and social media, which all can emphasize immediate gratification without reflection of judgment. Studies show, however, that bad things are more likely to happen when teenagers use only peers for reference when they do risky things. There are more accidents when cars are driven with other kids there; parties with only teenagers present are more likely to include alcohol, drugs and unprotected or forced sex, and so on. American parents and other significant adults are often reluctant to help young people balance their biological push toward action and novelty with the wisdom, judgment and forethought that comes from adult experience. The remedy is pretty simple - staying involved with your teenager's life will protect her, teach her needed skills, and will offer you unexpected benefits in learning and growth for yourself. Behind every successful teenager there is usually a wise adult, a parent, coach, teacher, big brother, or mentor. But this reality is seldom mentioned when the tale of success is told, which perpetuates the American myth of solitary and singular achievement. When we talk about building emotional muscle in parents and children, we describe a lifelong process of transforming the parent-child relationship rather than separating from your child. It is never too late to start developing the parental emotional muscles needed to start and maintain a rich conversation with your teenager. Teenagers, too, can learn how much they gain by "checking in before you check out."

Many young adults come to the
realization that the methods they used to feel comfortable are also
limiting their ability to feel like they are solidly a part of the adult
world. They waiver between making their world smaller and smaller and
trying to venture outside of their comfort zone and then being
overwhelmed by anxiety.

Young adults frequently reach out for help for the first time when they go to college. This can be because college is more stressful, or because the support their parents provided at home is either no longer available to them, or because they don't want their parents to protect them in the ways they did when they were younger. Young adults with overwhelming anxiety may have had some issues with feeling socially comfortable when they were younger, but everyone from parents, teachers to the teen themself may have hoped they would outgrow the difficulty.

If you look up panic disorder, social anxiety disorder or other phobias online, you will see many differing recommendations. Psychoanalysts have worked with people who complain of these symptoms for more than 100 years. Current scientific evidence demonstrates that Psychoanalysis is effective with these types of issues. Exploring the thoughts that occur at the time of anxiety, as well as understanding the meaning of the fears that one has can help to change the way one cope's with the world, making one's world a bigger place.

Below are some suggested psychoanalytic articles related to social anxiety disorder, panic disorder and phobia.

ABSTRACT This is the third part of a review and commentary on the psychoanalytic literature on phobias. This section takes up agoraphobia and other phobias of adults, and suggests further avenues for interpenetration of psychoanalytic and psychiatric approaches.

"Mr. L. experienced an impressive resolution of his panic disorder and obsessive-compulsive disorder symptoms in fourteen months of weekly to twice-weekly psychotherapy. Although he was able to function moderately well in a competitive university setting, his life remained restricted and he routinely felt frustrated and unable to manage his irrational fears and difficulties in social situations. His approach to his schoolwork remained conflicted. Despite his increased understanding of the meaning of his panic attacks, central aspects of the dynamic function of his anxiety remained opaque to him. This left Mr. L. in a state in which his mastery of anxiety symptoms and his control over his behavior felt tenuous and seemed tied to his self-imposed restricted life-style. In the psychotherapeutic work, his conscious fear of my hurting him, or doing something to him, was more extreme than it has been in his analysis. Sitting opposite from me in psychotherapy, Mr. L. would try to gauge from moment to moment how crazy I thought he was, and would imagine what I would do to him (medication, hospitalization, etc.). As a result, he was afraid to tell me everything of which he was aware, and the atmosphere was often excited and tense. In analysis, the fact that these scary ideas were fantasies became clearly apparent to him, and he was consequently able to talk more freely."